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1079 Chapter 7:Worker guides • Section 2: SNAP worker guides (07/2026) Form # Title/Use Paper Forms server PDF fill in DHS 1465 Able-Bodied Adult Without Dependents (ABAWD) Report of Good Cause or Exemption Can be used by the customer to report good cause or an exemption. The report can be verbal instead of using the form. X X MSC 2099 Authorization for Use and Disclosure of Information Used in instances where the individual is unable to provide necessary verification. The form gives ODHS|OHA permission to contact a specific person or organization and share information about the individual in order to verify eligibility. X X X MSC 3400 Information and Referrals for Low-Income Households Given to all SNAP households at each certification and recertification when they have income below 200% FPL. X X DHS 7254 Oregon Telephone Assistance Program Notice and application to the individual that because they are eligible for benefits, they can apply for a discount on their monthly telephone bill. X X AFS 7262 Direct Deposit –- A Safer, Easier Way to Put Your Benefits in Your Account Used for individuals in Cash-out counties using direct deposit. X MSC 9001 Individual Complaint Information Form explains individual complaint procedures, should they perceive that they are being treated with discrimination. It is mandatory for use with all applications. X X MSC 9013 We Want to Serve You Well (Contained in individual application packets DHS 6608 & MSC 6623 only) An information only pamphlet that tells individuals how to file a grievance. X X Outreach publications Form # Title/Use Paper Forms server PDF fill in DHS 848 Your SNAP food benefits may increase by reporting your expenses Individual brochure on expenses which may be used as an income deduction for SNAP X X